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吉西他滨联合多西他赛治疗晚期骨与软组织肉瘤的开放标签、非随机、Ⅱ期临床研究方案

Gemcitabine and docetaxel combination chemotherapy for advanced bone and soft tissue sarcomas: protocol for an open-label, non-randomised, Phase 2 study.

机构信息

Department of Orthopaedic Surgery, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan.

Division of Orthopaedic Surgery, Kobe University International Clinical Cancer Research Centre, 1-5-1 Minatojimaminami-cho, Chuo-ku, Kobe, 650-0047, Japan.

出版信息

BMC Cancer. 2019 Jul 23;19(1):725. doi: 10.1186/s12885-019-5923-7.

Abstract

BACKGROUND

The prognosis of patients with metastatic or advanced sarcomas is poor and there are few options for treatment. Several studies have shown that gemcitabine and docetaxel (GD) combination chemotherapy has antitumor activity against various subtypes of sarcoma. Recently, some studies have shown a favourable outcome for GD combination chemotherapy for relapsed high-grade osteosarcoma and spindle cell sarcoma of bone. If the effectiveness of GD is proven, this will result in new treatment options for advanced bone and soft tissue sarcomas (STS). The aim of this prospective Phase 2 study is to evaluate the efficacy and toxicity of the GD combination in patients with advanced bone sarcomas and STS.

METHODS

This is a Phase 2, single-arm, open-label study to investigate the efficacy and safety of combination chemotherapy with GD for advanced bone sarcomas and STS and will enrol 20 patients. The patients will receive gemcitabine 900 mg/m on Days 1 and 8, and docetaxel 70 mg/m on Day 8 in 3-week cycles until disease progression or other evidence of treatment failure. The primary aim of this study is to analyse GD's effect on progression-free survival (PFS). The secondary objectives are to analyse treatment efficacy and safety in terms of response rate, tumour control rate, overall survival, and adverse event rate. The length of follow-up will be 5 years.

DISCUSSION

This study will evaluate the efficacy and safety of combination therapy with gemcitabine and docetaxel for bone sarcomas and STS. If this combination proves to be acceptable, it could be used for as second, third, or later line therapy for patients with sarcomas (especially bone sarcomas). In the future, the role of various treatments, including GD therapy, will be clarified for specific subtypes of sarcoma.

TRIAL REGISTRATION

This study was registered as UMIN000031004 (University Hospital Medical Information Network-Clinical Trial Registry: UMIN-CTR) on 1 March 1 2018 and with the Japan Registry of Clinical Trials (jRCT) as jRCTs051180042 on 30 January 2019. The posted information will be updated as needed to reflect protocol amendments and study progress.

摘要

背景

转移性或晚期肉瘤患者的预后较差,治疗选择有限。几项研究表明,吉西他滨和多西他赛(GD)联合化疗对各种亚型肉瘤具有抗肿瘤活性。最近,一些研究表明,GD 联合化疗治疗复发性高级骨肉瘤和骨梭形细胞肉瘤具有良好的疗效。如果 GD 的有效性得到证实,这将为晚期骨和软组织肉瘤(STS)提供新的治疗选择。本前瞻性 2 期研究旨在评估 GD 联合化疗治疗晚期骨肉瘤和 STS 的疗效和毒性。

方法

这是一项 2 期、单臂、开放标签研究,旨在研究 GD 联合化疗治疗晚期骨肉瘤和 STS 的疗效和安全性,将纳入 20 例患者。患者将接受吉西他滨 900mg/m2 于第 1 天和第 8 天,多西他赛 70mg/m2 于第 8 天,每 3 周 1 个周期,直至疾病进展或其他治疗失败证据。本研究的主要目的是分析 GD 对无进展生存期(PFS)的影响。次要目标是分析反应率、肿瘤控制率、总生存期和不良事件发生率来评估治疗的疗效和安全性。随访时间为 5 年。

讨论

本研究将评估吉西他滨和多西他赛联合治疗骨肉瘤和 STS 的疗效和安全性。如果这种联合治疗被证明是可以接受的,它可以作为肉瘤患者(特别是骨肉瘤患者)的二线、三线或更后线治疗。在未来,将明确包括 GD 治疗在内的各种治疗方法在特定亚型肉瘤中的作用。

试验注册

该研究于 2018 年 3 月 1 日在大学医院医疗信息网络-临床试验注册中心(UMIN000031004)和日本临床试验注册中心(jRCT)进行注册,注册号为 jRCTs051180042。将根据需要发布信息更新,以反映方案修正案和研究进展。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7273/6651911/9c916e8bdd21/12885_2019_5923_Fig1_HTML.jpg

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